2D Measurements Flashcards
what is the normal TAPSE value ?
16 mm or greater
what is the normal EF for men ?
52 - 72 %
what is the normal EF for women ?
54 - 74%
maximum LA volume for men/women ?
16- 34 ml
what is normal RV pressure ?
systole: 15 - 25 mmHg
diastole: 2- 8 mmHg
what is the normal LV pressure ?
systole: 120 mmHg
diastole: 3-12 mmHg
what is the normal pressure for PA ?
systole: 15-25 mmHg
diastole: 4-12 mmHg
wall motion terms:
what does hibernation mean ?
ischemic segment that is akinetic (no movement), but not infarcted, that can be reversed with restoration of coronary blood flow
what does dyskinetic mean ?
movement away from the center of the cavity
SV volume equation ?
SV = EDV - ESV
*normal range: 70-100 ml
what is cardiac output (CO) ?
volume of blood that LV pumps each minute
CO equation ?
CO = SV x HR
what is the normal range of CO ?
4-8 L
what is BSA ?
body surface area
what is the normal BSA for adults ?
1.73 m2
BSA equation ?
BSA = (height x weight / 3131) (1/2)
- unit: inches and lbs
- US machine automatically calculates BSA
what is cardiac index (CI) ?
cardiac output correlated for the BSA
CI equation ?
normal value ?
CI = CO/BSA
3-4 L/min2
what is inotropic force ?
contractility of the heart muscle or the force of contraction
chronotropic force
rate of contraction or heart rate
afterload
the resistance that the heart must pump against
preload
the volume in the heart at end[-diastole
Amyl nitrite inhalation
less common maneuver that causes decreased peripheral resistance, which increases the heart rate, SV, and CO
inspiration/squatting _____ venous return, SV, and CO; expiration/standing _____ venous return, SV, and CO
increase
decrease
EF formula ? (Teicholts method)
EF% = LVIDV - LVISV/LVIDV x 100
*normal range for 20+ year old: 53-73%
LVH severity scale: men
normal value ?
mild value ?
severe value ?
6-10 mm
11-13 mm
> and = 17 mm
LVH severity scale: women
normal value ?
mild value ?
severe value ?
6-9 mm
10-12 mm
> and = 16 mm
pulsus paradoxus
an exaggeration of the normal decrease in systolic blood pressure. to be considered abnormal, the drop must be greater than 10 mmHg . it is associated with cardiac tamponade
thrills
palpable manifestations of loud, harsh murmurs with low frequency components. thrills are associated with AS and PS as well as VSD
cachexia
a state of ill health, malnutrition and wasting and is associated with long standing heart disease
Cor pulmonale
combination of hypertrophy and dilatation of RV caused by PH that results from a process intrinsic to the lung
juglar venous distention
a term widely used to indicate high pressure in the right heart
describe diastolic dysfunction
ventricles’ ability to relax and fill
3 things things that may impact 3DE by causing artifact
- respiration
- EKG gating
- incorrect gain setting
Frank-Sterling Law
the greater the amount of blood entering the chamber (greater preload), the greater the contraction (force) required to expel the blood
what is Interval-Strength Relationship ?
the longer the interval between heartbeats, the stronger the contraction to eject the blood
what is PAP ?
pulmonary artery perssure
what are the 3 layers of the myocardium ?
epicardium
myocardium
endocardium
Cartesian coordinate system
x = width y = height z = depth
describe 3 factors that may impact cardiac afterload
- AS/PS
- systemic hypertension
- PH
strain phase _____ venous return, SV, CO and release phase ______ venous return, SV, CO
decrease
increase
the degree of fiber stretch depends on the quantity of the blood in the chamber prior to contraction. T or F ?
T
*LVEDP: LV end diastolic pressure
M-mod evaluation:
normally when the MV opens on M-mod the anterior and posterior leaflets move _____ of each other (anterior leaflet ____ & posterior leaflet _____).
opposite
upwards
downwards
when there is significant MS, the anterior and posterior leaflets move in the ______ direction ______.
same
upwards
where is Thebesian valve located ?
between CS and RA
what are thebasian veins ?
numerous, minute veins. return blood from the myocardium directly into cardiac chambers w/o entering the cardiac venous system
adult TTE TDR have a frequency range of ______
2.0 - 3.5 MHz
describe steps to improve image resolution for TTE (at least 4)
- image minimum depth
- utilize the highest possible TDR frequency
- adjust gains, dynamic range
- adjust frame rate
- utilize harmonic imaging
list wall segments that are seen in the PSAX view ( 6 segments)
- anteroseptal wall
- anterior wall
- anterio-lateral wall
- infero-lateral wall
- inferior wall
- infero-septal wall
when demonstrating flow across the AoV in the A5, flow moving systematically will appear ____ the base line with CW and _______ with color Doppler
below
blue
list at least 4 major technical areas that are controls on your u/s system that should be adjusted as you begin your echocardiogram
- frequency
- gain
- harmonics
- ECG signal
your patient has a history of emphysema. what might you encounter as you perform their echocardiogram ?
patients with a history of emphysema often demonstrate hyperinflated lungs that may cause difficult parasternal window views. subcostal windows are typically the best window in patients with emphysema
list items that are part of info inputted into the u/s system as you begin your echo (at least 4)
- patient ID
- patient full name
- DOB
- indication of exam
- height & weight
- BP
advantage of M-mod assessment of LV size and function are:
high temporal resolution
reproducible
much published data
list 4 limitation of M-mod
- frequently off-axis beam alignment
- one dimensional
- assume fixed geometry
- applies only to normal LV geometry
- misleading if LV is remodeling i.e. dilated CM
Doppler echo has two primary forms: _____ and ______
spectral and color flow
________ is a technique used to process signals so that directionally or spatially selected signals can be sent or received from sensor arrays
beamforming
ultrasound artifacts can occur when the basic assumption inherent in the system design regarding sound waves is not followed. which of the following is not inherent assumption?
sound travels in perpendicular lines
advantage of M-mode ?
- much published data
- reproducible
- high temporal resolution
aliasing occurs when the velocity is _____ while using pulsed Doppler
> 2m/s
